GOP HEALTH AGENDA: NOT JUST REPEAL – With a Republican electoral wave looming large, health strategists are exploring which key health programs and authorizations a newfound GOP majority could upend—and they’re not just talking about the health reform law. PULSE caught up with Dean Rosen, former chief health adviser to then-Senate Majority Leader Bill Frist and now partner at lobby shop Mehlman Vogel Castagnetti, to get his take on what non-reform agenda items we should keep an eye on:

--TWO BIRDS, ONE STONE – Republicans could raid health reform funds to pay for the “doc fix” that they will need to pass ASAP: a six-month patch approved this summer, which prevented a double-digit cut to Medicare doctor payments, expires December 1. Defunding a PPACA provision to offset much-needed Medicare funds would come with an easy-to-sell message: “The rhetorical argument would be, we shouldn’t be committing new funds to a new program when we already have shortfalls in certain entitlements,” says Rosen.

--AUTHORIZATIONS NOT AS NORMAL – Rosen hears chatter, albeit nascent, “that even some of the existing health program authorizations or reauthorizations are going to have to be paid for with offsets that need to be identified or won’t grow as much.” Two on his radar: the Prescription Drug User Fee Act and the Device User Fee Act.

--FAREWELL, FMAP – Even though many Republican governors requested the extended Medicaid funds this past summer, they’re likely to pipe down in the coming session. “While the Republican governors wanted the money, they may be willing to tighten their belts as well and be less vocal,” he says. “When I was on the Hill, many of us opposed these kinds of programs as a way to finance the states.” The current FMAP extension runs through June 2011.

OVERNIGHT: HEALTH DRIVES VOTES – It’s the second-most important voting issue after the job situation, Pew Research Center found in its last pre-election poll, out late Sunday. The 53 percent who cited health care as one of their top two issues split evenly across parties: 47 percent Republican, 46 percent Democrats. Republicans, however, were much more likely to list health as their number one voting issue. Full results http://bit.ly/c4yrBs

STATES ENACT LAST-MINUTE REFORMS BEFORE ELECTION - At least two states with contested gubernatorial races on Tuesday – and potential flips from a Democrat to a Republican state leader – announced new programs in recent days to step up their reform plans:

-- ILLINOIS SETS RATE REPORTING REQUIREMENTS – The state’s DOI on Sunday announced new reporting requirements for premium increases by the state’s insurers. They’ll have to submit rate changes and justification beginning Dec. 1. In February, insurers can submit the information online. “The enhanced reporting requirements announced today will lead to better and more reliable information for Illinois’ families, employers and policymakers,” Illinois DOI Director Michael McRaith said in a statement.

--WYOMING TO START REFORM TASK FORCE – Wyoming has been one of the slowest states to start implementing the health care reform law, but Gov. Dave Freudenthal last week established a task force to study whether and how the state is going to establish a health insurance exchange. The Casper Star-Tribune article http://bit.ly/bbPNa9

--MORE FROM WYOMING – Freudenthal “has decided on health care that he’ll pick and choose when to participate when … it’s optional,” said Dan Neal, executive director of the Equality State Policy Center, which is part of Consumer Advocates: Project Healthcare, a coalition to promote the consumer’s role in health reforms. The group views Thursday’s announcement as a “positive,” but Tuesday’s election will have a more substantial impact on the future of the reform law in Wyoming. “So much depends on who the person ultimately elected is, and what their position is,” Neal tells PULSE. Republican Matt Mead is favored in the election and he has opposed the law, while the Democratic candidate has been more supportive.

FEINGOLD ON THE TRAIL – POLITICO’s Ben Smith’s dispatch from the staunch reform defender’s embattled campaign: “The irony is biting: While other Democrats ran away from health care, Feingold ran toward it and rallied a progressive base that adores him. But no matter, he’s still losing, down in every public poll and struggling in pretty much the same way embattled Democrats around the country are — as symbols of the status quo and of the unpopular health care legislation.” http://politi.co/aKayW6LAST-MINUTE AD SPENDING BY MEDICAL GROUPS – A number of medical-related PACs used the last weekend before the midterms to throw a final round of money into the races.

--National Nurses United for Patient Protection is out with $28,000 in radio advertising in support of Patrick Murphy (PA-08), $4,000 in support of Colleen Hanabusa (HI-01), $14,000 in support of Ami Bera (CA-03), $9,000 in support of Gary Peters (MI-09) and $2,000 in support of Phil Hare (IL-17).

--The American Society of Anesthesiologists PAC dropped $50,000 each in support of Andy Harris (MD-01), Larry Bucshon (IN-08) and Charlie Dent (PA-15).

--The Cooperative of American Physicians-Mutual Protection Trust PAC dropped $10,000 on television ads for Ken Buck, who is in a down-to-the-wire race for Colorado Senate.

--Sixty Plus Association, a prolific spender in the midterms, is out with $98,000 in media opposing Tim Bishop (NY-01).

--The National Emergency Medicine PAC is spending $35,000 on candidate mailings in support of Joe Heck (NV-03).

STEARNS: KEEP AGE 26, PRE-EX PROVISIONS – From Tony Romm’s profile of Cliff Stearns, the Florida Republican gunning against Upton, Barton and Shimkus for E&C’s top spot: “Stearns promised a series of hearings and a new bill that would keep some elements of Democrats’ health care package while adding in many of the ideas GOP leaders supported earlier this year. That new effort would retain rules that would allow young adults to stay on their parents’ plans until age 26, while stipulating ‘some understanding that people with preexisting conditions should be taken care of,’ he said. It would also substitute in more robust provisions on preventative care and medical liability reform, as well as some of the other health care items that Stearns and others first pitched as part of a 1994 health care bill.” The POLITICO story http://politi.co/dnLnFV

--KHN also out with a rundown on how a GOP-controlled House could attack reform. http://bit.ly/csNFsf

ABORTION BATTLE RAGES IN DAHLKEMPER’S DISTRICT - Catholics United has a full-page ad in the Erie Times defending Rep. Kathy Dahlkemper’s pro-reform vote. The ad, which ran Sunday and today, has dozens of local faith leaders arguing that health reform “maintains all current restrictions prohibiting taxpayer funding for abortion” and urging Susan B. Anthony List to stop “false allegations” suggesting otherwise. SBA List ran an ad in the same paper Friday, with a copy of the USCCB statement opposing reform. Catholics United Ad http://politi.co/acsXpv Susan B. Anthony List Ad http://politi.co/aY5Dc6

PAWLENTY ALLOWS A GRANT - Minnesota will accept federal assistance under the Democrats’ health reform law after all, despite Gov. Tim Pawlenty’s executive order barring voluntary participation in federal health care programs. Pawlenty spokesman Bruce Gordon says participation in the new program does not violate the executive order because it promulgates existing state polices. POLITICO story http://politi.co/dpIjPT

BARBOUR: HEALTH REFORM WON’T BE RECOGNIZABLE - Asked Sunday during an interview on NBC's “Meet the Press” if Republicans will be able to follow through on their pledge to repeal health care, the Mississippi governor said, “If they don't fully repeal and replace it, they will make such big changes in it over the next few years that you won't recognize it.” More at POLITICO http://politi.co/dogrp6

LAST WEEK’S HEALTH LOBBY REGISTRATIONS - Just one last week: CliniComp International.

WHAT WE’RE READING:

Arizona, Colorado and Oklahoma voters will have a chance Tuesday to vote on the health law’s insurance mandate, Kaiser Health News reports. http://bit.ly/axkCqT

BCBSA pushes back against an NAIC model law draft, which reminds states that they can force carriers back into their child-only markets, Inside Health Policy reports (subscription required). http://bit.ly/aE9jbi

In Florida, Sen. Bill Nelson explains why reform’s Medicare cuts are necessary. “We cannot sustain the cost increases over time,” he said at a Friday night event, the Polk County Ledger reports. http://bit.ly/cyYTyr

Iowa’s Republican candidate for attorney general campaigns on her intention to join a repeal lawsuit. http://bit.ly/cKJhfB

Reader's Comments (1)

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